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Development of clinical and laboratory biomarkers in an international cohort of 428 children with lupus nephritis.
- Source :
-
Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Oct; Vol. 39 (10), pp. 2959-2968. Date of Electronic Publication: 2024 May 28. - Publication Year :
- 2024
-
Abstract
- Background: Lupus nephritis (LN) is a very severe manifestation of lupus. There is no consensus on which treatment goals should be achieved to protect kidney function in children with LN.<br />Methods: We retrospectively analyzed trends of commonly used laboratory biomarkers of 428 patients (≤ 18 years old) with biopsy-proven LN class ≥ III. We compared data of patients who developed stable kidney remission from 6 to 24 months with those who did not.<br />Results: Twenty-five percent of patients maintained kidney stable remission while 75% did not. More patients with stable kidney remission showed normal hemoglobin and erythrocyte sedimentation rate from 6 to 24 months compared to the group without stable kidney remission. eGFR ≥ 90 ml/min/1.73m <superscript>2</superscript> at onset predicted the development of stable kidney remission (93.8%) compared to 64.7% in those without stable remission (P < 0.00001). At diagnosis, 5.9% and 20.2% of the patients showed no proteinuria in the group with and without stable kidney remission, respectively (P = 0.0001). dsDNA antibodies decreased from onset of treatment mainly during the first 3 months in all groups, but more than 50% of all patients in both groups never normalized after 6 months. Complement C3 and C4 increased mainly in the first 3 months in all patients without any significant difference.<br />Conclusions: Normal eGFR and the absence of proteinuria at onset were predictors of stable kidney remission. Significantly more children showed normal levels of Hb and erythrocyte sedimentation rate (ESR) from 6 to 24 months in the group with stable kidney remission.<br /> (© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
- Subjects :
- Humans
Child
Female
Male
Retrospective Studies
Adolescent
Blood Sedimentation
Remission Induction
Kidney pathology
Kidney physiopathology
Complement C3 analysis
Complement C3 metabolism
Antibodies, Antinuclear blood
Proteinuria etiology
Proteinuria urine
Proteinuria blood
Proteinuria diagnosis
Complement C4 analysis
Complement C4 metabolism
Child, Preschool
Lupus Nephritis blood
Lupus Nephritis diagnosis
Biomarkers blood
Glomerular Filtration Rate
Subjects
Details
- Language :
- English
- ISSN :
- 1432-198X
- Volume :
- 39
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 38802607
- Full Text :
- https://doi.org/10.1007/s00467-024-06405-6